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Imaging

It is generally accepted that stage I and II breast cancer does not require staging. Stage II is divided into stage IIA and stage IIB based on tumor size and whether it has spread to the axillary lymph nodes (the lymph nodes under the arm). In stage IIA, the cancer is either not larger than 2 centimeters and has spread to the axillary lymph nodes, or between 2 and 5 centimeters but has not spread to the axillary lymph nodes. In stage IIB, the cancer

Lay Summary: CAD is still investigational for breast MRI. The use of computer-aided detection (CAD) is proposed to supplement radiologists' interpretation of contrast-enhanced magnetic resonance imaging (MRI) of the breast. MRI of the breast is sometimes used as an alternative to mammography or other screening and diagnostic tests because of its high sensitivity in detecting breast lesions, even among those women—for example, younger women and

Breast tomosynthesis is a 3-dimensional (3-D) imaging technology that involves acquiring images of a stationary compressed breast at multiple angles during a short scan. The individual images are then reconstructed into a series of thin high-resolution slices that displayed individually or in a dynamic ciné mode. Tomosynthesis can reduce or eliminate the tissue overlap effect. While holding the breast stationary, images are acquired at a number

Scintimammography is independent of tissue density is a functional imaging technique. As such it has appea for dignostic use but it remains investigtional even for this application. It is not established for screening, or, as in this case, surveillance. It also ahs a potnetial use an adjunct to mammography. Clinical studies have not clearly demonstrated the ability of scintimammography to differentiate between benign and malignant breast lesions,

18F-fluorodeoxyglucose (FDG) PET is increasingly used in restaging advanced or recurrent breast cancer and in monitoring response to therapy and has received approval for Medicare re-imbursement for these clinical indications. CMS covers PET for breast cancer staging except axillary staging. It covers FDG PET as an adjunct to standard imaging modalities for staging patients with distant metastasis, restaging patients with locoregional recurrence

The American College of Radiology (ACR) has established guidelines to help uniformly assess the criteria for performing stereotactically guided breast biopsy for each modality including MRI. The ACR recommends that lesion visualization and access, availability of the imaging modality, efficiency, safety, and the practitioner's experience are all used to determine the best guidance technique. The MRI-guided biopsy is more cost-effective compared to

The use of MRI before breast surgery is increasing based on reports that show that MRI can detect previously unknown foci of breast cancer in a substantial number of women with a new diagnosis of breast cancer. However, some argue that MRI will increase the proportion of mastectomy because it will cause more extensive surgeries. Since breast conservation surgery combined with radiation therapy as major advantages with similarly low recurrence rates

The time course to the appearance of clinically detected distant metastases of breast cancer is extremely long. It is common for metastases to manifest 10 years or more after the initial diagnosis of breast cancer. It is generally accepted that least invasive methods for evaluating suspected metastases should be employed. The few studies that compared MRI, PET and bne scan found them to be simlarly effective. Bone scan is preferred to MRI in this

Most guidelines recommend breast MRI for screening in women with high-risk of developing breast cancer and to clarify diagnostic uncertainties after mammography and ultrasound. As use of MRI has increased, many other situations for which, MRI might be helpful came to the fore. Unfortunately, literature support for most of them, is lacking. Currently, guidelines indicate MRI for screening of women at high risk based on family history or for clarifying